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Diets rich in sodium chloride are common among Americans, 90 percent of whom exceed the recommended 2,300 mg intake of salt per day. While such diets have been linked with an increased risk for cerebrovascular diseases and dementia, exactly how high levels of salt damage the brain remained unclear.

I’m used to seeing insurance companies here in the United States make decisions about MS therapies, including refusing to pay for certain treatments unless other, less expensive ones are tried first. These, of course, are decisions that should be made between patients and their doctors, not by insurers. Now, I’ve learned of an attempt in the U.K. to blacklist an entire class of MS therapies for patients in England and Wales.

On Dec. 20, NICE recommended that four of the five beta-interferon MS therapies ― Avonex (interferon beta-1a), Betaferon (interferon beta-1b), Plegridy(peginterferon beta-1a) and Rebif (interferon beta-1a) ― should no longer be prescribed to new MS patients or to people who want to change their therapies. Copaxone (glatiramer acetate) also is on the “no” list. Only Extavia(interferon beta-1b) should be prescribed, in the opinion of NICE.

The reason: NICE thinks that all of those treatments have a similar clinical effect, but only Extavia is cost-effective. And that’s because Extavia’s manufacturer, Novartis, has agreed to sell the therapy to the NHS at a discount.

Moving in the wrong direction

The U.K.’s MS Society calls this a “significant step backwards,” and I agree. In my experience, MS patients react differently to different disease-modifying therapies (DMT). In the real patient world, some treatments actually are more effective than others. Patients also react differently, in terms of side effects, to different DMTs. Not to mention the very important fact that treating a disease is personal. Treatments should be based upon a collaboration between a patient and a doctor. They should not be decided based on which pharmaceutical company cut the best deal with an insurer or a government health plan.

“We want the companies who make these [other] drugs to keep negotiating and come to a deal with NICE and NHS England so patients don’t lose out,”the MS Society’s Genevieve Edwards said. “Everyone with MS should be able to get fair and equal access to the right treatments at the right time.”

Non-Hispanic whites, especially females, are more likely to die from multiple sclerosis (MS) than any other racial group, though blacks tend to die earlier, concludes a study by researchers at UCLA’s Keck School of Medicine.

Researchers classified death records into five racial/ethnic groups: non-Hispanic white, non-Hispanic black, non-Hispanic Asian or Pacific Islander, non-Hispanic American Indian or Alaska Native, and Hispanic of any race. Then they calculated the age-adjusted and age-specific MS mortality rate (per 100,000 individuals) by race/ethnicity and sex over time.

Of the 59,462 patients analyzed, 66 percent were women and 34 percent were men. Death rates were highest among non-Hispanic whites, which accounted for 86 percent of all MS-caused deaths in the period analyzed.

Non-Hispanic females had an MS-related death rate of 1.5 per 100,000 inhabitants — the highest of all ethnic groups — compared to 0.9 per 100,000 for non-Hispanic females. Likewise, the rate for non-Hispanic black women was 1.42, and for non-Hispanic black men, 0.75 per 100,000. By contrast, MS killed only 0.12 of every 100,000 females of Pacific island origin, and only 0.05 of every 100,000 males in that same ethnic group.

According to the survey, Hispanics, American Indians and Alaska Natives had similarly lower age-adjusted MS mortality rates when compared to non-Hispanic blacks and whites.

The analysis also revealed a rapidly rising trend of MS-specific mortality among non-Hispanics in general, and a strong age-specific mortality pattern in non-Hispanic blacks, with higher mortality rates among those younger than 55, and non-Hispanic whites, who had the highest mortality rate after that age point.

“This may suggest that the burden of disease weighs differently by race/ethnicity at least in the United States,” researchers wrote. “For these two groups, MS mortality increased with age in both sexes and peaked at ages 55-64 for NH blacks and 65-74 for NH whites before declining substantially.”

Among non-Hispanic Asian or Pacific Islanders, Hispanics and American Indian or Alaska Natives, the risk plateaued after 55 years old.

Overall, these results suggest that MS-specific mortality is affected by race/ethnicity and age, and that whites and females — the two groups most affected by the disease — are at higher risk of dying from MS.

CannaMD plans two medical marijuana clinics in the Orlando area to evaluate patients for entry in the Florida Medical Marijuana Use Registry. The first clinic opened Jan. 17 in the suburb of Dr. Phillips; the second will open Jan. 25 in the Lake County town of Mt. Dora.

CannaMD is a statewide network of doctors and clinics that aims to provide alternative medicine to patients with multiple sclerosis (MS) and other diseases. In recent years, medical marijuana has become a popular way to treat pain, muscle spasms and other symptoms.

“We understand the heartache and discouragement experienced by patients and their family members as they search for a better way to manage debilitating health conditions,” the company’s founder, Ryan Scotson, said in a press release. “Our patients receive individualized care and we are dedicated to sharing our knowledge by educating the public about the benefits of medical marijuana.”

The registry is an online database that lets patients and physicians order medical marijuana. To enter, patients must first be evaluated in person by a certified physician. Only after a doctor determines that they qualify for medical marijuana can patients be registered.

SYMPTOMS of MS

In multiple sclerosis , damage to the myelin in the central nervous system (CNS), and to the nerve fibers themselves, interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the primary symptoms of MS, which vary depending on where the damage has occurred.

Over the course of the disease, some symptoms will come and go, while others may be more lasting.

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